Abstract This study identifies the effect of the public policy implemented in the State of Ecuador in 2008 in regard to democratization of access to higher education, being understood as a right that reduces the existing gaps between men and women, ethnicities and quintiles; for this purpose, a mixed methodology is used as the starting point and, using a qualitative analysis, a review of the main legal instruments regulating higher education in Ecuador was performed, along with specific articles related to this subject. For quantitative methodology, the starting points were reports of the National Information System (SNI) in regards to net rate of enrollment in higher education, managed by the National Secretariat of Planning in order to perform a descriptive analysis on its evolution in gender, ethnicity and registration quintiles. Among the main results obtained, it was determined that the gratuity policy did have a positive effect for access to higher education for men, women, African-Ecuadorian and indigenous peoples and, for quintiles 1, 2 and 3 until year 2011, a noticeable increase was seen in nationwide net rate of enrollment with 4.95 percentile points between 2007 and 2011, until the meritocracy policy entered in force in 2012.

Resumen Esta investigación identifica el efecto de la política pública implementada en 2008 por el Estado ecuatoriano referente a la democratización del acceso a la educación superior, entendida como un derecho que reduce las brechas que existen entre hombres y mujeres, etnias y quintiles; para ello, se parte de una metodología mixta, en la que, dentro del análisis cualitativo, se revisan los principales instrumentos legales que regulan la educación superior en Ecuador, y artículos seleccionados sobre la temática. En la metodología cuantitativa, se parte de los reportes del Sistema Nacional de Información (SNI) referentes a la tasa neta de matrícula en educación superior, administrado por la Secretaría Nacional de Planificación, para realizar un análisis descriptivo sobre su evolución a nivel de sexo, etnia y quintiles de ingreso. Entre los principales resultados, se determina que la política de gratuidad tuvo un efecto positivo en el acceso a la educación superior, para hombres, mujeres, afroecuatorianos e indígenas, y en los quintiles 1, 2 y 3, hasta el año 2011, evidenciando un incremento en la tasa neta de matrícula a nivel nacional, de 2007 a 2011, de 4,95 puntos porcentuales, hasta que entró en vigor la política de meritocracia, en 2012.

Resumo A investigação identifica o efeito da política pública implementada no ano 2008 pelo Estado equatoriano em relação à democratização do acesso à educação superior, entendida a jeito de direito que reduze as divisões existentes entre homens e mulheres, etnias e quintis; para esse propósito, usou-se uma metodologia mista na que, dentro da análise qualitativa, examinaram -se os instrumentos legais principais de regulação da educação superior no Equador, além de artigos escolhidos da área temática. Dentro da metodologia quantitativa, usaram-se os reportes do Sistema Nacional de Informação (SNI) referentes à taxa líquida de matrícula na educação superior aportado pela Secretaria Nacional de Planificação, para fazer uma análise descritiva da evolução em relação ao sexo, etnia e quintis de admissão. Entre os resultados principais, determinou-se que a política de gratuidade teve um efeito positivo no acesso à educação superior para homens, mulheres, afro-equatorianos e indígenas e, nos quintis 1, 2 e 3, até o ano 2011, observou-se um incremento na taxa líquida de matrícula ao nível nacional entre os anos 2007 ao 2011, com 4.95 pontos percentis, até o começo da validade da política de meritocracia no 2012.

Abstract Background Recently, it was demonstrated that allopurinol, a xanthine oxidase inhibitor, has cardiovascular and anti-ischaemic properties and may be a metabolic antianginal agent option.Objective: The objective of this study was to evaluate the antianginal effect of allopurinol as a third drug for patients with stable coronary artery disease (CAD). Methods This was a randomized clinical trial between 2018 and 2020 including patients with CAD who maintained angina despite initial optimization with beta-blockers and calcium channel blockers. The individuals were randomized 1:1 to 300 mg of allopurinol twice daily or 35 mg of trimetazidine twice daily. The main outcome was the difference in the angina frequency domain of the Seattle Angina Questionnaire (SAQ-AF). A probability (p) value < 0.05 was considered statistically significant. Results A hundred and eight patients were included in the randomization phase, with 54 (50%) in the allopurinol group and 54 (50%) in the trimetazidine group. Six (5.6%) individuals, 3 from each group, were lost to follow-up for the primary outcome. In the allopurinol and trimetazidine groups, the median SAQ-AF scores were 50 (30.0 to 70.0) and 50 (21.3 to 78.3), respectively. In both groups, the SAQ-AF score improved, but the median of the difference compared to baseline was lower in the allopurinol group (10 [0 to 30] versus 20 [10 to 40]; p < 0.001), as was the mean of the difference in the total SAQ score (12.8 ± 17.8 versus 21.2 ± 15.9; p = 0.014). Conclusion Both allopurinol and trimetazidine improved the control of angina symptoms; however, trimetazidine presented a greater gain compared to baseline. Brazilian Registry of Clinical Trials - Registration Number RBR-5kh98y Recently inhibitor antiischaemic anti ischaemic option.Objective optionObjective option Objective CAD. . (CAD) 201 202 betablockers beta blockers 11 1 1: 30 SAQAF. SAQAF AF (SAQ-AF) (p 005 0 05 0.0 significant phase 5 50% (50% 5.6% 56 6 (5.6% followup follow up groups 30.0 (30. 70.0 700 70 21.3 213 21 (21. 78.3, 783 78.3 , 78 78.3) respectively 10 (1 [ 2 [1 40 40] 0.001, 0001 0.001 001 0.001) 12.8 128 12 8 (12. 178 17 17. 212 21. 15.9 159 15 9 0.014. 0014 0.014 014 0.014) symptoms however RBR5kh98y RBRkhy RBR 5kh98y kh y (CAD (SAQ-AF 00 0. (50 5.6 (5.6 30. (30 70. 7 (21 78. ( 4 000 0.00 12. (12 15. 0.01 01 khy (5 5. (5. (3 (2

Resumo Fundamento Recentemente, foi demonstrado que o alopurinol, um inibidor da xantina oxidase, possui propriedades cardiovasculares e anti-isquêmicas e pode ser uma opção de agente antianginoso metabólico. Objetivo O objetivo do presente estudo foi avaliar o efeito antianginoso do alopurinol como terceiro medicamento para pacientes com doença arterial coronariana (DAC) estável. Métodos Trata-se de um ensaio clínico randomizado entre 2018 e 2020 incluindo pacientes com DAC que mantiveram angina apesar da otimização inicial com betabloqueadores e bloqueadores dos canais de cálcio. Os indivíduos foram randomizados 1:1 para 300 mg de alopurinol 2 vezes ao dia ou 35 mg de trimetazidina 2 vezes ao dia. O desfecho principal foi a diferença no domínio da frequência da angina do Questionário de Angina de Seattle (QAS-FA). Foram considerados estatisticamente significativos valores de probabilidade (p) < 0,05. Resultados Foram incluídos 108 pacientes na fase de randomização, com 54 (50%) no grupo alopurinol e 54 (50%) no grupo trimetazidina. Seis (5,6%) indivíduos, 3 de cada grupo, foram perdidos no seguimento para o desfecho primário. Nos grupos de alopurinol e trimetazidina, as pontuações medianas do QAS-FA foram 50 (30,0 a 70,0) e 50 (21,3 a 78,3), respectivamente. Em ambos os grupos, a pontuação do QAS-FA melhorou, mas a mediana da diferença em relação à linha de base foi menor no grupo alopurinol (10 [0 a 30] versus 20 [10 a 40]; p < 0,001), assim como a média da diferença na pontuação total do QAS (12,8 ± 17,8 versus 21,2 ± 15,9; p = 0,014). Conclusão Tanto o alopurinol quanto a trimetazidina melhoraram o controle dos sintomas de angina; no entanto, a trimetazidina apresentou um ganho maior em relação à linha de base. Registro Brasileiro de Ensaios Clínicos – Número de Registro RBR-5kh98y Recentemente oxidase antiisquêmicas anti isquêmicas metabólico (DAC estável Tratase Trata se 201 202 cálcio 11 1 1: 30 QASFA. QASFA FA . (QAS-FA) (p 005 0 05 0,05 10 randomização 5 50% (50% 5,6% 56 6 (5,6% primário 30,0 (30, 70,0 700 70 21,3 213 21 (21, 78,3, 783 78,3 , 78 78,3) respectivamente melhorou (1 [ [1 40 40] 0,001, 0001 0,001 001 0,001) 12,8 128 12 8 (12, 178 17 17, 212 21, 15,9 159 15 9 0,014. 0014 0,014 014 0,014) entanto RBR5kh98y RBRkhy RBR 5kh98y kh y (QAS-FA 00 0,0 (50 5,6 (5,6 30, (30 70, 7 (21 78, ( 4 000 0,00 12, (12 15, 0,01 01 khy 0, (5 5, (5, (3 (2

Resumen La presente contribución propone abordar al registro como herramienta metodológica situada en el ámbito de la extensión universitaria y en relación con los procesos de aprendizaje en los dispositivos. El objetivo es, por un lado, presentar las principales características de la construcción de registros de las experiencias a lo largo de las prácticas de extensión, sus alcances y limitaciones. Por otro lado, reflexionar sobre las instancias pedagógicas donde realizamos la lectura de esos registros, un “descentramiento teórico” en que nos permiten establecer asociaciones, formular preguntas impensadas, generar hipótesis. Dos momentos que se retroalimentan. En este sentido, consideramos que el registro es una herramienta metodológica de sumo valor cognoscitivo que permite recuperar las experiencias y se convierte en materia prima para la interpretación y análisis de esos procesos, en diálogo con la teoría a través de instancias de escritura.

Abstract The present contribution proposes to approach registration as a methodological tool situated in the field of university extension and in relation to learning processes in the devices. The objective focuses, on the one hand, on presenting the main characteristics of the construction of records of experiences throughout extension practices, their scope and limitations. On the other hand, to reflect on the pedagogical instances where we read those records, a “theoretical decentering” that allows us to establish associations, formulate unanticipated questions, generate hypotheses. Two moments that mutually feed back. In this sense, we consider registration to be a methodological tool of great cognitive value that allows us to recover experiences, and becomes raw material for the interpretation and analysis of those processes in dialogue with theory through writing instances.

Resumo A presente contribuição propõe abordar o registro como uma ferramenta metodológica situada no âmbito da extensão universitária e em relação aos processos de aprendizagem nos dispositivos. O objetivo se centra, por um lado, em apresentar as principais características da construção de registros das experiências ao longo das práticas de extensão, seus alcances e limitações. Por outro lado, refletir sobre as instâncias pedagógicas onde realizamos a leitura desses registros, um “descentramento teórico” que nos permite estabelecer associações, formular perguntas inesperadas, gerar hipóteses. Dois momentos que se retroalimentam mutuamente. Neste sentido, consideramos que o registro é uma ferramenta metodológica de notável valor cognitivo que permite recuperar as experiências e se torna matéria-prima para a interpretação e análise desses processos em diálogo com a teoria através de instâncias de escrita.

ABSTRACT Foundation: hypertension has become one of the most prevalent conditions among Cuban adults and the main risk factor for morbidity and mortality due to cardiovascular causes. Objective: to evaluate the impact of the implementation of the Arterial Hypertension Program Based on the HEARTS Initiative in the Octavio de la Concepción y de la Pedraja Community Polyclinic in the Cienfuegos municipality. Methods: a descriptive, cross-sectional study was carried out in health systems and services from 2018 to 2022. The universe was the population over 18 years of age and the sample of 4,346 hypertensive patients. The variables were studied: sex, control of high blood pressure, technological structure, performance index, maturity index and mortality behavior due to cardiovascular diseases. Results: the performance index of the Basic Health Teams was excellent and the maturity index was in the advanced category. 85.5 % diagnostic and registration coverage were achieved, 94.7 % control among treated patients, 39.5 % control of patients with high cardiovascular risk and 60.1 % population control. Mortality from cardiovascular diseases for all ages, specifically premature mortality, decreased, with a predominance of the male sex. Conclusions: the implementation of the arterial hypertension program consolidated a work system for the improvement of action in Primary Health Care for hypertensive patients. The use of standardized therapeutic policy has had an impact on blood pressure control.

RESUMEN Fundamento: la hipertensión se ha convertido en una de las condiciones de mayor prevalencia entre los adultos cubanos y en el principal factor de riesgo de morbilidad y de mortalidad por causas cardiovasculares. Objetivo: evaluar el impacto de la implementación del Programa de Hipertensión Arterial basado en la Iniciativa HEARTS en el Policlínico Comunitario Octavio de la Concepción y de la Pedraja en el municipio Cienfuegos. Métodos: se realizó un estudio descriptivo, de corte transversal en sistemas y servicios de salud desde el 2018 hasta el 2022. El universo fue la población mayor de 18 años y la muestra de 4 346 hipertensos. Se estudiaron las variables: sexo, control de hipertensión arterial, estructura tecnológica, índice de desempeño, índice de madurez y comportamiento de la mortalidad por enfermedades cardiovasculares. Resultados: el índice de desempeño de los Equipos Básicos de Salud fue excelente y el índice de madurez tuvo la categoría de avanzado. Se alcanzó el 85,5 % de cobertura diagnóstica y de registro, el 94,7 % de control entre tratados, un 39,5 % de control de los pacientes con alto riesgo cardiovascular y el 60,1 % de control poblacional. La mortalidad por enfermedades cardiovasculares para todas las edades en específico la mortalidad prematura disminuyó, con predominio del sexo masculino. Conclusiones: la implementación del programa de hipertensión arterial consolidó un sistema de trabajo para el perfeccionamiento de actuación en la Atención Primaria de Salud ante el paciente hipertenso. El uso de la política terapéutica estandarizada ha tenido impacto en el control de la presión arterial.

BACKGROUND. The COVID-19 pandemic highlighted the weakness of relying on in-person tuition in higher education. Massive open online courses (MOOCs) have been a successful addition to higher education. In this study, educators had to replace a planned elective in the medical curriculum with an online option during the pandemic. The roles of the competency framework of the Health Professions Council of South Africa (HPCSA) (Leader and Manager, Health Advocate, Professional, Communicator, Collaborator, Scholar, and Healthcare Practitioner) were used to guide its development. This elective emphasised the non-clinical roles of medical practitioners and was offered in 2020 and 2021. OBJECTIVES. To describe the choices of third-year medical students and time spent participating in a modified online elective in 2020 and 2021. METHODS. A descriptive cross-sectional study design was used, involving the participation of 629 medical students. Data were collected and analysed from three primary sources: registration data from LinkedIn Learning, data from the Foundation for Professional Development, and self-reported estimates by students of the average time spent on selected courses. Data included identification of the associated competency acquired. Data analysis was conducted using Python, version 3.10.11. RESULTS. The course choices of 629 students were analysed. In 2020 there were 300 participants and in 2021 there were 329. All the students had one compulsory inclusion in the elective (Management and Leadership Short Course for Undergraduate Healthcare Students). Students in both years reported spending the most average time on courses related to clinical knowledge (Healthcare Practitioner), followed by financial literacy and management (Professional), diversity management (Collaborator), and priority actions to identify and/or respond to (Health Advocate). The most popular courses related to the Leader and Manager role were around decision-making in human resources, problem-solving, and managing healthcare teams. Based on the top 10 LinkedIn Learning course selections of both cohorts, there appeared to be a preference for courses that were consistent with the role of medical professionals in practice. The most popular LinkedIn Learning course was The Six Morning Habits of High Performers. CONCLUSION. Students gravitated toward courses aligned with their role as professional doctors within the HPCSA competency framework. More studies are needed to understand how medical students develop the six non-clinical roles in the HPCSA framework and the effectiveness of MOOCs in a medical curriculum.

RESUMEN Objetivo: Evaluar el efecto de la movilización activa temprana (MAT) en comparación con el cuidado habitual activo (CHA) en sujetos adultos críticamente enfermos respecto de la fuerza muscular y del estado funcional. Materiales y métodos: Se realizó una revisión sistemática con metaanálisis. Se incluyeron ensayos clínicos aleatorizados que compararon la MAT con el CHA en sujetos >18 años, de ambos sexos, en estado crítico durante o después del período de ventilación mecánica en la unidad de cuidados intensivos (UCI). La búsqueda se realizó en las bases de datos Cochrane, Medline/Pubmed, Embase (Elsevier), SciELO, LILACS/BVS, www.controlled-trials.com/, clinicaltrials.gov/ y www.who.int/ictrp/en/. Se analizó el riesgo de sesgo mediante la herramienta RoB 1. Se generó una síntesis cualitativa y cuantitativa (metaanálisis) de los resultados. Registro: OSF: https://bit.ly/430fF72. Resultados: Se incluyeron siete estudios, con un total de 1905 sujetos. La mayoría de los sujetos eran del sexo masculino (57 %) y tenían entre 54 y 66 años. Los desenlaces reportados mostraron baja certeza de evidencia, según la Clasificación de la valoración, desarrollo y evaluación de las recomendaciones (GRADE, por sus siglas en inglés). En el metaanálisis del estado funcional al alta hospitalaria, se observó un efecto a favor del grupo MAT, con una diferencia de medias estandarizada de 0,26 (IC 95 % 0,11 - 0,41) y baja heterogeneidad (I2 = 0 %). Conclusión: Con una baja certeza de evidencia, el efecto de la MAT en sujetos adultos críticamente enfermos en la UCI podría mejorar el estado funcional al alta hospitalaria en comparación con el CHA.

ABSTRACT Objective: To evaluate the effect of early active mobilization (EAM) compared to active usual care (AUC) in critically ill adult subjects regarding muscle strength and functional status. Materials and methods: A systematic review with meta-analysis were conducted. Randomized clinical trials comparing EAM with AUC in subjects >18 years of age, of both sexes, in critical condition during or after the period of mechanical ventilation in the intensive care unit (ICU) were included. The search was performed in the Cochrane, Medline/Pubmed, Embase (Elsevier), SciELO, LILACS/BVS, www.controlled-trials.com/, clinicaltrials.gov/, and www.who.int/ictrp/en/ databases. Bias risk was assessed using the RoB 1 tool. A qualitative and quantitative synthesis (meta-analysis) of the results was generated. Registration: OSF: https://bit.ly/430fF72. Results: Seven studies were included in this review, comprising a total of 1905 subjects. The majority of subjects were male (57 %) and aged between 54 and 66 years. The reported outcomes showed low certainty of evidence, according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. In the meta-analysis of functional status at hospital discharge, a favorable effect was observed in the EAM group, with a standardized mean difference of 0.26 (95 % CI 0.11 - 0.41) and low heterogeneity (I2 = 0 %). Conclusion: With low certainty of evidence, the effect of EAM on critically ill adult subjects in the ICU may improve functional status at hospital discharge compared to AUC.

Abstract Aim: To compare obesity progression and the type2 diabetes mellitus (T2DM) metabolic control between 2017 and 2019, according to sodium-glucose cotransporter type 2 inhibitors (SGLT2i) or not therapy, in the T2D population of the Central Administrative Portuguese National Health Service Authority, the ARS do Centro. Methods: Observational retrospective cohort study in 2021 of data by the informatic services of ARS do Centro, after ethics consent: gender, age, year of ICPC2 T90 classification, abdominal perimeter (AP), body mass index (BMI), last glycated haemoglobin (HbA1c) in 2017 and 2019 and drugs registered in the e.registration official program, the S-Clínico Diabetes. Results: Out of the 127,062 T2DM patients of the ARS do Centro n=16.012 (12.6%) were on SGLT2i in 2017. The mean age was 73.5±10.1 years, the time since ICPC classification was 8.7±4.2 years and 48.8% were males. HbA1C, BMI and AP values between 2017 and 2019 were independent for age and time since diagnosis, |rS| <0.400. Median HbA1c values between the two moments, in the total sample and the subgroups medicated with SGLT2i and per gender were significantly different (p<0.001) values increasing. No difference was observed in the subgroups not SGLT2i treated, either globally (p=0.983) or per gender (M: p=0.932; F: p=0.932). BMI in SGLT2i treated T2DM showed significant negative variation (p<0.001) also observed in nonSGLT2i treated ones (p=0.004). AP values significantly increased in nonSGLT2i T2DM patients (p=0.001) and significantly decreased in the SGLT2i treated ones (p<0.001). Discussion: The efficacy of SGLT2i in clinical assays and its effectiveness in real-world patients must be ascertained. Obesity decrease in BMI or AP can contribute to future T2DM analytics control. Conclusion: SGLT2i significantly decreased BMI and prevented AP increase, compared to non-SGLT2 T2DM patients. HbA1c control, in a 2-year gap, showed no decrease in growth.

Resumo Objetivo: Comparar a progressão da obesidade e do controlo metabólico entre 2017 e 2019, pela terapêutica farmacológica com inibidores da SGLT2 (iSGLT2) em doentes com diabetes mellitus tipo 2 (DM2) na área da Administração Regional de Saúde do Centro (ARS Centro). Métodos: Estudo observacional de coorte retrospetiva em 2021, segundo dados fornecidos pelos serviços informáticos da ARS Centro, após consentimento ético institucional quanto a sexo, idade, ano de classificação DM2, perímetro abdominal (PA), índice de massa corporal (IMC), última avaliação de HbA1c em 2017 e em 2019 e medicamentos assinalados no programa S-Clínico de diabetes. Resultados: De 127.062 doentes com DM2, 16.012 (12,6%) estavam medicados com iSGLT2, 48,8% do sexo masculino, a idade média de 73,5±10,1 anos e o tempo desde classificação DM2 de 8,7±4,2 anos. Para HbA1C, IMC e PA entre ambos os pontos de análise mostraram-se independentes da idade e do tempo desde o diagnóstico: |rS|<0,400. Verificou-se diferença significativa entre os valores medianos de HbA1c em 2017 e 2019 no total e nos subgrupos medicados com SGLT2i, globalmente e por sexo (p<0,001). Nos não medicados com iSGLT2 não foi observada diferença significativa globalmente (p=0,983) e por sexo (M: p=0,932; F: p=0,932). O IMC em sujeitos sob iSGLT2 reduziu significativamente (p<0,001) como no grupo medicado com outros fármacos (p=0,004). O PA aumentou significativamente no grupo não iSGLT2 (p=0,001) e teve redução significativa no grupo sob SGLT2i (<0,001). Discussão: A eficácia dos iSGLT2 observada em ensaios clínicos deve ser verificada em doentes do mundo real, a efetividade. A redução da obesidade por IMC e por PA pode ser fator de futuro controlo de DM2. Conclusão: A terapêutica com iSGLT2 reduziu significativamente o IMC e o PA em comparação com o grupo controlo. O controlo da DM2 pela HbA1c neste espaço de dois anos não revelou crescimento.

Abstract The purpose of this article is to make visible and analyze the political, institutional, and bureaucratic-administrative framework involved in the consolidation of the electoral strength of the immigrant population residing in the province of Buenos Aires (Argentina). In this province, since 1999, the automatic registration of foreigners who meet legal requirements has been recognized. The analysis focuses on the registration policy and on electoral authorization to show that this is a longterm process, in which there are significant discontinuities between the stages of sanction, regulation, and application. It is also based on a qualitative methodological approach centered on the consultation and comprehensive analysis of a diverse set of primary and secondary statistical and documentary sources, as well as key informant interviews. It is concluded that the political call for automatic voter registration, embodied in the letter of the law and resulting from a genuine struggle for the expansion of political rights, has required extremely complex institutional designs on which significant progress has been made in recent years, but which, at present, continue to rely largely on the sum of wills and ad hoc political synergies.

Resumen El propósito del artículo es visibilizar y analizar la trama política, institucional y burocrático-administrativa implicada en la consolidación de la fuerza electoral de la población inmigrante residente en la provincia de Buenos Aires (Argentina). En esta provincia se reconoce, desde 1999, el empadronamiento automático de las personas extranjeras que cumplen con los requisitos exigidos por la ley. El análisis se centra en la política de registro y en la habilitación electoral, para mostrar que se trata de un proceso de largo aliento, en el que se observan discontinuidades importantes entre las etapas de sanción, regulación y aplicación. Asimismo, se sustenta en un enfoque metodológico cualitativo centrado en la consulta y en el análisis integral de un conjunto diverso de fuentes estadísticas y documentales primarias y secundarias, así como de entrevistas a informantes clave. Se concluye que la consigna política del empadronamiento automático, plasmada en la letra de la ley y resultante de una lucha de ampliación de derechos políticos genuina, ha requerido de diseños institucionales sumamente complejos sobre los cuales se han producido importantes avances en los últimos años, pero que, en la actualidad, siguen descansando en gran medida en la sumatoria de voluntades y sinergias políticas ad hoc.

Abstract: El objetivo principal de este trabajo es analizar el fenómeno de la formación y éxito de nuevos partidos en el período de redemocratización y retorno del multipartidismo brasileño (1979-2018). Aunque el fenómeno es recurrente en Brasil, pocos estudios han abordado el tema de forma más directa en este país. ¿Cuáles son los determinantes de la formación continua de nuevos partidos? Nuestra respuesta apunta a estrategias partidarias combinadas con incentivos contenidos por reglas electorales fluctuantes. Utilizamos metodologías anteriores y conceptualizamos los partidos nuevos como aquellos que son nuevos desde el punto de vista organizativo (obtienen un nuevo registro) y obtienen al menos un escaño en la Cámara de Diputados. Dividimos a los partidos en función de si fueron fundados como partidos de contestación o de coaptación para evaluar el diferente impacto de las variables institucionales y económicas sobre ellos. Nuestros resultados indican que a los partidos totalmente "fuera del sistema" (los de contestación) les resulta más difícil llegar a ser competitivos, lo que demuestra que el fenómeno de la aparición de nuevas siglas está más vinculado a una reorganización estratégica de las élites que a una demanda de los votantes.

Resumen: The main objective of this paper is to analyze the phenomenon of the formation and success of new parties in the period of redemocratization and the return of the Brazilian multiparty system (1979-2018). Although the phenomenon is recurrent in Brazil, few studies have looked more directly at the subject in Brazil. What are the determinants of the continuous formation of new parties? Our answer points to party strategies combined with incentives contained by fluctuating electoral rules. We used previous methodologies and conceptualized new parties as those that are organizationally new (gain a new registration) and win at least one seat in the Chamber of Deputies. We divided the parties by whether they were founded as contestation or coaptation parties in order to assess the different impact of institutional and economic variables on them. Our findings indicate that parties totally "outside the system" (those of contestation) find it more difficult to become competitive, demonstrating that the phenomenon of the emergence of new acronyms is linked more to a strategic reorganization of the elites than to a demand from voters.

Abstract The process of Internationalization of a fashion brand requires a prior strategy in which the monetary resources available to allocate to the registry are valued, the urgency of filing applications in markets where the brand is already being marketed and the intention to expand exports of the product in the future and, consequently increasing the countries in which protection will have to be requested. The Madrid System is a useful and advantageous alternative for trademark owners who have a limited budget and require extensive brand protection, also giving them the ability to add designations at a later stage.

Resumen El proceso de Internacionalización de una marca de moda requiere una estrategia previa en la que se valoren los recursos monetarios disponibles para destinar al registro, la urgencia de presentar solicitudes en mercados donde ya se está comercializando la marca, así como la intención de ampliar la exportación del producto en el futuro, aumentándose en consecuencia los países en los que habrá de solicitarse protección. El Sistema de Madrid es una alternativa útil y ventajosa para los titulares de marcas que cuentan con un presupuesto limitado y requieren de una protección amplia de su marca, brindándoles además la posibilidad de agregar designaciones en una etapa posterior.

Resumo O processo de Internacionalização de uma marca de moda requer uma estratégia prévia em que sejam valorizados os recursos monetários disponíveis para destinar ao cadastro, a urgência de pedidos de depósito em mercados onde a marca já é comercializada e a intenção de expandir as exportações do produto no futuro e, conseqüentemente, aumentando os países nos quais a proteção deverá ser solicitada. O Sistema de Madrid é uma alternativa útil e vantajosa para proprietários de marcas registradas que têm um orçamento limitado e precisam de proteção de marca extensa, dando-lhes também a capacidade de adicionar designações em um estágio posterior.

Abstract Creativity in the fashion industry deserves protection and one of the most important vehicles is commercial brands, as it is an intangible asset that allows products and services to be distinguished. That is why technology is relevant to provide robust protection and this is done by an adequate surveillance system. In this way, it seeks to avoid conflicts on the Internet or for the registration of other trademarks.

Resumen La creatividad en la industria de la moda merece protección y uno de los vehículos más importantes son las marcas comerciales, pues es un activo intangible que permite distinguir productos y servicios. Es por ello que la tecnología es relevante para brindar una robusta protección y ello se realiza por un sistema de vigilancia adecuado. De esta manera su busca evitar los conflictos en Internet o por el registro de otras marcas comerciales.

Resumo A criatividade na indústria da moda merece proteção e um dos veículos mais importantes são as marcas, pois é um ativo intangível que permite diferenciar produtos e serviços. É por isso que a tecnologia é relevante para fornecer proteção robusta e isso é feito por um sistema de vigilância adequado. Dessa forma, busca evitar conflitos na Internet ou pelo registro de outras marcas.

Resumen Se presentan 16 libros cuya impresión se realizó en el estado de Puebla y fueron publicados entre 1640-1700, todos tienen la característica de ser ejemplares únicos hasta la fecha. Dichas obras consideradas únicas están disponibles en tres bibliotecas mexicanas: Biblioteca Nacional de México, Biblioteca Eusebio Dávalos Hurtado y Biblioteca Palafoxiana. Los criterios para determinar la unicidad consisten: que, en el universo de bibliotecas mexicanas con catálogo en línea disponible para su consulta, tengan libros poblanos del periodo que comprende de 1640 a 1700, que esos libros poseen un registro disponible, que se trate de un impreso en formato original. La investigación se basa en los principios del Patrimonio Bibliográfico histórico, principalmente utiliza el método bibliográfico tradicional enfocado en la búsqueda de libros antiguos, ambos conceptos inherentes a las instituciones bibliotecarias, cuya finalidad radica en su protección, registro, difusión y cuidado de libros.

Abstract This paper presented 16 books from Puebla, published between 1640-1700, all of them have the characteristic of being unique copies to date. These Puebla books considered unique are available in 3 mexican libraries: National Library of Mexico, Eusebio Dávalos Hurtado Library and Palafoxiana Library. The criteria to determine the uniqueness of the print are: that the universe of Mexican libraries with an online catalog available for consultation have Puebla books from the period 1640 to 1700, the books have an available record, that it is a print in original format. The research is based on the principles of historical Bibliographic Heritage, mainly using the traditional Bibliographic Method focused on the search for ancient books, both concepts inherent to library institutions, whose purpose is their protection, registration, dissemination and care of books.

Resumo En el mundo andino, la vida en comunidad es una de las manifestaciones culturales más importantes, donde la gratitud -dentro de su cosmovisión-es una práctica ancestral denominada “ayni”, esta expresa varias connotaciones, una de ellas es el “buen vivir” o “allin kawsay” que fueron inculcados desde el seno familiar, tal es el caso de los estudiantes de la Universidad Nacional del Altiplano de Puno (UNA-Puno) que aún practican estas costumbres. El objetivo de estudio es analizar la gratitud hacia la familia como expresión del buen vivir de los estudiantes universitarios del ande peruano. Se recurre a la investigación de enfoque cualitativo, métodos fenomenológico y etnográfico, con diseño no experimental de corte transversal, se ejecutaron 339 entrevistas semiestructuradas a estudiantes provincianos de la UNA -Puno. Se aplicó el modelo de reducción de datos cualitativos (edición, categorización y codificación, registro y tabulación), permitiendo obtener diferentes versiones, testimonios y opiniones de gratitud de los universitarios hacia sus familias. Se concluye que la gratitud -como filosofía del buen vivir-está arraigada a la importancia de vivir en familia; el no decepcionar a sus padres es una motivación para salir adelante como reconocimiento al sacrificio y esfuerzo que reciben por brindarles mejores oportunidades de vida; que incluso a pesar de sus desaciertos reciben el apoyo incondicional, es por ello que expresan su admiración y agradecimiento, no sólo a sus padres sino a toda su familia (hermanos, abuelos, tíos y hasta padrinos). Finalmente, el hecho de terminar sus estudios superiores para ser buenos profesionales es un acto de reciprocidad hacia sus seres queridos y comunidad.

Abstract In the Andean world, community life is one of the most important cultural manifestations, where gratitude -within their cosmovision-is an ancestral practice called "ayni", this expresses several connotations, one of them is the "good living" or "allin kawsay" that were instilled from within the family, such is the case of the students of the National University of Altiplano Puno, who still practice these traditions. The aim of the study is to analyze gratitude towards the family as an expression of the good life of university students in the Peruvian Andes. The research is based on a qualitative approach, phenomenological and ethnographic methods, with a non-experimental cross-sectional design. 339 semi-structured interviews were conducted with students from the provinces of UNA-Puno. The qualitative data reduction model was applied (editing, categorization and coding, registration and tabulation), allowing to obtain different versions, testimonies and opinions of gratitude of university students towards their families. It is concluded that gratitude -as a philosophy of good living -is rooted in the importance of living as a family; not disappointing their parents is a motivation to move forward in recognition of the sacrifice and effort they receive for providing them with better life opportunities; that even in spite of their mistakes they receive unconditional support, which is why they express their admiration and gratitude, not only to their parents but to their entire family (brothers, grandparents, uncles and aunts, uncles and even godparents). Finally, the fact of finishing their higher education to become good professionals is an act of reciprocity towards their loved ones and community.

Resumen Antecedentes La medición de la hemoglobina glucosilada A1c (HbA1c) con un valor por debajo del 7% indica un adecuado control glucémico. Los esquemas farmacológicos están basados en cinco clases terapéuticas. Objetivo Describir los esquemas de tratamiento utilizados y hacer una comparación indirecta de ellos, con respecto al control de la glucosa determinada por la HbA1c, en pacientes con diabetes mellitus tipo 2 (DM2). Material y métodos Estudio descriptivo, transversal y retrospectivo, con muestreo sistemático. Fue aprobado con número de registro R-2022-2402-046. Información basada en expedientes entre enero de 2019 y diciembre de 2022. Se incluyeron pacientes con DM2, mayores de 18 años, de ambos sexos, con Hb1Ac reciente, parámetro de control 7% o menos, y con el mismo tratamiento farmacológico por lo menos 3 meses. Se excluyeron pacientes con diabetes mellitus tipo 1 y con diabetes gestacional. Análisis con estadística descriptiva. Resultados Se incluyeron 180 mujeres (64.1%) y 101 hombres (35.9%). Se utilizaron 58 esquemas farmacológicos diferentes. Porcentajes de control de HbA1c: monoterapia 50%, terapia dual 45%, terapia triple 48% y esquema cuádruple 28%. Conclusiones El porcentaje de control glucémico varía según el tipo de tratamiento farmacológico y existe poco uso de fármacos nuevos. El gran número de esquemas utilizados revela que no se estandarizan tratamientos, sino que se considera la individualidad del paciente.

Abstract Background The glicated hemoglobin A1c(HbA1c) measurement, whose value is below 7% indicates adequate glycemic control. The pharmacological regimens are based on five therapeutic classes. Objective Describe the treatment schemes used and make an indirectly compare them concerning glucose control, determined by HbA1c, in patients with type 2 diabetes mellitus (DM2). Materials and methods Descriptive, cross-sectional and retrospective study, with systematic sampling. Registration number R-2022-2402-046 was approved. Information based on records between January 2019 and December 2022. Patients with DM2, over 18 years of age, both sexes, with recent Hb1Ac, control parameter 7% or less and with the same pharmacological treatment for at least 3 months were included. Type 1 and gestational diabetes were excluded. Analysis with descriptive statistics. Results 180 women (64.1%) and 101 men (35.9%) were included. 58 pharmacological regimens were used (58). HbA1c control percentages: monotherapy 50%, dual therapy 45%, triple therapy 48% and quadruple regimen 28% were used. Conclusions The percentage of glucose control varies about the type of pharmacological treatment and there is little use of new drugs. The large number of schemes used reveals not standardizing treatments, but rather considering the individuality of the patient.

Abstract The thesis that the Brazilian state tolerates and encourages urban squatting as a response to its own inability to provide popular housing and to guarantee jobs that enable the acquisition of housing in the real estate market is tested in this article through the case study of Florianópolis. We studied irregularity and two indications of municipal action in its consolidation in Florianópolis: implementation of community facilities and issuance of construction permits. We found that construction permits are limited only by registration restrictions, not by the existence or not of land ownership, and that the municipality works actively in the production of health, education, and transport facilities, but not of leisure facilities in these areas. Florianópolis restrictions ownership health education areas

Resumo A tese de que o estado brasileiro tolera e fomenta as ocupações urbanas irregulares como resposta à sua própria incapacidade de prover habitação popular e de garantir empregos que permitam a aquisição de habitação no mercado imobiliário é testada neste artigo, por meio do estudo do caso de Florianópolis. Estudou-se a irregularidade no município e dois indicativos de atuação municipal na sua consolidação: implementação de equipamentos comunitários e emissão de alvarás de construção. Verificou-se que os alvarás de construção em ocupações irregulares são limitados somente por restrições registrais, mas não pela existência ou não de propriedade da terra e que o município trabalha ativamente na produção de equipamentos de saúde, educação e transporte, mas não de lazer nessas áreas. artigo Florianópolis Estudouse Estudou se consolidação Verificouse Verificou registrais saúde transporte áreas